Better identification and prioritisation of the immunosuppressed is the first step to mitigating the very real threat COVID-19 continues to present to these patients. This cannot be done without the consensus of world experts.

The objectives of The DESTINIES Study are to:

1. Refine the UK’s current characterisation of immunosuppression, using international best practice to identify absences and propose substitutions,

2. Reach agreement on how this clinical risk group might be subdivided based on risk for severe COVID-19 outcomes and

3. Shape international discussion and viewpoints about immunosuppression and vulnerable groups more generally.

To achieve this, the eDelphi Consortium will undertake three rounds of eDelphi consensus building: two rounds of questionnaires and a final discussion group to try to resolve ongoing points of disagreement.

Leveraging their professional experiences and grasp of current literature, panellists will assess the appropriateness of various conditions for a working definition of immunosuppression before evaluating their vulnerability for COVID-19 in turn. Consensus statements on challenges associated with defining, treating and protecting immunosuppressed patients will be presented alongside questions that establish how drug-management, time since diagnosis/ last treatment, duration of treatment and duration of remission modifies infection risk.